Division of Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
University Hospital Frankfurt, Department of Orthopedics (Friedrichsheim), Movement Analysis Lab, Goethe University Frankfurt, Frankfurt am Main, Germany.
Br J Sports Med. 2021 Dec;55(23):1366-1378. doi: 10.1136/bjsports-2021-103933. Epub 2021 Aug 3.
To compare the effects of pre-planned and unplanned movement tasks on knee biomechanics in uninjured individuals.
Systematic review with meta-analysis.
Five databases (PubMed, Google Scholar, Cochrane Library, ScienceDirect and Web of Science) were searched from inception to November 2020. Cross-sectional, (randomised) controlled/non-controlled trials comparing knee angles/moments of pre-planned and unplanned single-leg landings/cuttings were included. Quality of evidence was assessed using the tool of the Grading of Recommendations Assessment, Development and Evaluation working group.
A multilevel meta-analysis with a robust random-effects meta-regression model was used to pool the standardised mean differences (SMD) of knee mechanics between pre-planned and unplanned tasks. The influence of possible effect modifiers (eg, competitive performance level) was examined in a moderator analysis.
Twenty-five trials (485 participants) with good methodological quality (Downs and Black) were identified. Quality of evidence was downgraded due to potential risk of bias (eg, confounding). Moderate-quality evidence indicates that unplanned tasks evoked significantly higher external knee abduction (SMD: 0.34, 95% CI: 0.16 to 0.51, 14 studies) and tibial internal rotation moments (SMD: 0.51, 95% CI: 0.23 to 0.79, 11 studies). No significant between-condition differences were detected for sagittal plane mechanics (p>0.05). According to the moderator analysis, increased abduction moments particularly occurred in non-professional athletes (SMD: 0.55, 95% CI: 0.14 to 0.95, 5 studies).
Unplanned movement entails higher knee abduction and tibial internal rotation moments, which could predispose for knee injury. Exercise professionals designing injury-prevention protocols, especially for non-elite athletes, should consider the implementation of assessments and exercises requiring time-constrained decision-making.
CRD42019140331.
比较计划性和非计划性单腿落地/变向任务对无损伤个体膝关节生物力学的影响。
系统评价和荟萃分析。
从建库至 2020 年 11 月，共检索了 5 个数据库（PubMed、Google Scholar、Cochrane Library、ScienceDirect 和 Web of Science）。纳入比较计划性和非计划性单腿落地/变向时膝关节角度/力矩的横断面研究和（随机）对照/非对照试验。使用推荐评估、制定与评估工作组的工具评估证据质量。
采用多级荟萃分析，使用稳健随机效应荟萃回归模型对计划性和非计划性任务中膝关节力学的标准化均数差值（SMD）进行汇总。在调节分析中检查了可能的调节变量（例如竞技表现水平）的影响。
确定了 25 项研究（485 名参与者），这些研究具有良好的方法学质量（Downs 和 Black）。由于潜在的偏倚风险（例如混杂因素），证据质量被降级。质量中等的证据表明，非计划性任务会引起明显更高的膝关节外展（SMD：0.34，95%CI：0.16 至 0.51，14 项研究）和胫骨内旋力矩（SMD：0.51，95%CI：0.23 至 0.79，11 项研究）。矢状面力学无明显的组间差异（p>0.05）。根据调节分析，非专业运动员的外展力矩增加尤其明显（SMD：0.55，95%CI：0.14 至 0.95，5 项研究）。
非计划性运动需要更高的膝关节外展和胫骨内旋力矩，这可能会增加膝关节受伤的风险。设计损伤预防方案的运动专业人员，尤其是针对非精英运动员，应考虑实施需要限时决策的评估和练习。
PROSPERO 注册号：CRD42019140331。
